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High resolution anoscopy (HRA) is a specialized procedure utilized for the detailed examination of the anal canal and surrounding tissues, particularly in patients who have exhibited abnormal results from anal cytology tests or anal Pap smears. This procedure is essential for the assessment of anal dysplasia, which refers to the presence of precancerous changes in the anal epithelium. During HRA, a high-resolution anoscope, which is a tubular instrument equipped with a magnifying lens, is employed to enhance the visualization of the anal mucosa. The anoscope is introduced into the anus with the aid of an obturator, which facilitates its insertion and is subsequently removed to allow for direct observation. The procedure involves careful inspection of the anal mucosa for any abnormal tissue, which may be indicative of dysplastic changes. To improve the clarity of the examination, a mildly acidic chemical agent may be applied to the identified areas of concern, enhancing the contrast and visibility of abnormal tissues. In conjunction with the visual assessment, biopsies may be performed to obtain tissue samples for further pathological evaluation, ensuring a comprehensive approach to diagnosing and managing anal dysplasia.
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High resolution anoscopy (HRA) is indicated for the evaluation of patients who have had abnormal anal cytology tests or anal Pap smears. The procedure is specifically performed to assess anal dysplasia, which may be a precursor to anal cancer. The following conditions warrant the use of HRA:
The procedure of high resolution anoscopy (HRA) involves several critical steps to ensure accurate evaluation and biopsy of abnormal tissues. The following outlines the procedural steps:
Following the high resolution anoscopy, patients may experience some discomfort or minor bleeding at the biopsy sites. It is important for patients to be monitored for any significant bleeding or adverse reactions. Instructions for post-procedure care typically include avoiding strenuous activities and following up with the healthcare provider for biopsy results and further management. Patients should be informed about potential symptoms to watch for, such as increased pain, fever, or excessive bleeding, and advised to seek medical attention if these occur.
| Short Descr | ANOSCOPY HRA W/BIOPSY | Medium Descr | ANOSCOPY HIGH RESOLUTION W/BIOPSY | Long Descr | Anoscopy, high resolution (HRA) (with magnification and chemical agent enhancement); with biopsy(ies) | Status Code | Carriers Price the Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | Not applicable/unspecified. | CCS Clinical Classification | 77 - Proctoscopy and anorectal biopsy |
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| 2015-01-01 | Deleted | Code deleted, see 46607 |
| 2011-01-01 | Added | First Appearance in Code Book |
| 2010-07-01 | Added | Added |
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